I went to visit my daughter this weekend. She lives about 2-1/5 hours away. Half way there I realized I had forgotten my medications.
I take three medications, two antidepressants and mood-stabilizer. I have been taking them for 7 years. Every day. Morning. Night. I don’t mess around and skip a day here or there. I take them without fail.
I did the math in my head. I took my last dose at 7 am Friday. I was not planning on getting home until at least 7 pm on Sunday. That would be 60 hours without my medications. Once I forgot to order a three-month supply of one of my antidepressants and ran out for about three days so I knew what it felt like to skip a few days without one of the medications.
I had never gone as long as 60 hours without all three. I knew I would feel some kind of withdrawal. I just didn’t know what to expect.
Every now and then I get a glimpse of what my mental illnesses look like.
It’s been a long time. I have taken my medications without fail for years. I exercise, eat healthy foods, get as much sleep as I can, visit my psych-nurse practitioner every three months and I get on my knees every night and thank God for my sobriety. In other word, I do what I am told – an unnatural act for me.
As a reporter for a daily newspaper, I am accustomed to stress. For nearly 30 years I have lived with a deadline hanging over my head. I took six weeks off to have a baby, 8 weeks for my last major depression but other than the one- or two-week vacations, I have had a deadline over my head.
Recently, I accepted an assignment which today I realize I should not have done. I agreed to leave my home and my dog, suspend my exercise routine and healthy eating habits and forego nights of 8-hours of sleep to cover the Florida legislature’s last two-weeks in session.
I did this once before, nearly 30 years ago when reporters were only expected to write a story for the newspaper. Now, we must also Tweet, blog and make videos. Despite my degree in political science, after 30+ years in journalism, I’m kinda disallusioned with politics.
We have a couple more studies that suggest that paralyzing key facial muscles with Botox can reduce the symptoms of depression.
In a recent 24-week randomized double-blind placebo-controlled study, done by Michelle Magid, MD, clinical associate professor of psychiatry at the University of Texas, 30 participants with depressive symptoms were randomized and give injections of Botox or a placebo between the eyebrows (which happens to be exactly where I need it.)
The men were injected with 39 units of botulinum and the women were injected with 29 units. At week 12, the placebo group crossed over to treatment, and the treatment group crossed over to placebo.Participants were evaluated at weeks 0, 3, 6, 12, 15, 18, and 24. The primary outcome was a reduction from baseline of at least 50% in the 21-item Hamilton Depression Rating Scale score.
In a yet-to-be-published study in the in the Journal of Psychiatric Research, Eric Finzi, a cosmetic dermatologist, and Norman Rosenthal, a professor of psychiatry at Georgetown Medical School, randomly assigned a group of 74 patients with major depression to receive either Botox or saline injections in the forehead muscles that enable us to frown.
An article published in today’s issue of the Journal of the American Medical Association has me kind of freaked out.
According to a press release advancing the article, Wide Variation Found in Quality of Evidence Used By FDA For Approval of New Drugs:
“Many patients and physicians assume that the safety and effectiveness of newly approved therapeutic agents is well understood; however, the strength of the clinical trial evidence supporting approval decisions by the U.S. FDA has not been evaluated.”
As someone who has been on not one, not two but a cocktail of three medications – two anti-depressants and a mood stabilizer – for more than seven years I am one of those persons who assumed that the safety and effectiveness of the drugs I take were established by the gold standard for evaluation: the randomized, double-blind study.
Apparently not. Dr. Joseph Ross and Nicholas Downing from the Yale University School of Medicine examined every FDA drug approval from 2005-2012. Their study included how many clinical trials were submitted to support the approval, how long the trials lasted, how many patients were studied and the outcomes used to define the drug’s effects and safety.
I don’t do resolutions but apparently a lot of people do because the gym was packed this morning.
If something needs to change, I change it. Relying on a number on a calender has never worked for me. Trust me. I’ve tried it. You can ask any alcoholic and they will tell you they have set deadlines and then either missed them or got sober for a few weeks and then they’re back at it.
It’s the same with dieting. If you can go ON a diet, you can go OFF a diet. You want to lose weight or quit smoking or drinking, you just do it – not because it’s a certain day of the year. Because it needs to be done and every cell in your body is convinced of that truth. In the words of the philosophers at Nike: Just do it.
Of course if you are as hard headed as I am, it may take some time to convince yourself that you really need to make a change. In fact, I brain has concocted truly ridiculous arguments to prove to myself that I didn’t need to quit drinking, take antidepressants or see a therapist.
Every Saturday morning I refill my pink pill box: S-M-T-W-T-F-S. I have been doing this for years. Three different medications. One of this pill. One of that pill. One-and-a-half of those pills. Every morning and every night, I take my meds. It’s like brushing my teeth – just something I do when I wake up and before I go to bed.
My meds. I go weeks without giving a thought to my meds. I just take them. My life is good. No more hopeless black holes or vibrating with energy like a wide-eyed racehorse pawing at the dirt in the starting gate. Nice and steady. I have grown used to it and I really, really like it.
So, when something comes along that has the potential to seriously disrupt my balance, I tend to freak out. Anxiety is the enemy. Drama is the enemy. I have made enough enemies in my life. I don’t need to make anymore.
There are three things that scare the hell out of me: Sharks. Being trapped in a car after an accident and cut out with the jaws of life; unemployment. As long as I stay out of the ocean and drive safely, I’m in good shape. Right now, unemployment is beyond my control.
And I like to be in control.
In July I blogged about Dr. John Christensen, a West Palm Beach doctor who was charged with two counts of first-degree murder for the overdose deaths of two patients he treated at his clinics, which investigators described as “pill mills.”
I am not a fan of the death penalty but not for the usual reasons. As someone who has sat through murder trials, walked down death row, interviewed condemned killers, actually sat in the electric chair and witnessed an execution – I have decided that capital punishment is futile, immoral and a monumental waste of tax-dollars.
If you really want to punish someone, lock them in a 6 x 9 foot cell for 30 or 40 years. The average length of stay on Florida’s death row is 13 years and many killers will tell you they would prefer to die than live out their lives in a box.
Although research has shown that the death penalty is not a deterrent, I suspect that executing a physician who knowingly prescribed massive doses of drugs to an addict who then overdosed, would be a deterrent to other physicians. A really, really big deterrent.
Fifteen years ago tonight I got very, very drunk. I don’t remember much of that night and what I do remember sickens me. I really hope that if my life flashes before me as I’m dying, this night is left out. I don’t really want to know what else happened that night.
Nothing has been the same since that night, August 27, 1998. It was simultaneously the worst and best night of my life. I hit bottom. I surrendered and started a new life- without drugs or alcohol. That night the first domino fell and since then I have learned that alcoholism is not my only mental illness. I also have hypomania – a kind of bipolar disorder with less dramatic and violent mood swings that bipolar I but my tendency is towards depression.
Getting sober was the beginning of my life making sense to me. If you do not have a mental illness, you may not understand how important it is for your life to make sense. Your life has probably always made sense to you.
My life was a disaster. I wasn’t even 40-years-old and I had already been through two marriages. I was a bitch. I had a lot of anger and spent a lot of time feeling sorry for myself. Removing the alcohol made life even more raw – like someone had taken a potato peeler to my soul. I not only had to learn how to live without alcohol, I had to learn to live. Period.
Having grown up in an alcoholic household and starting my own drinking/drugging career at 14, my social skills were a little lacking. I had to learn how to play well with others instead of conquering others. I had to learn to do things like apologize and mean it, tell the truth, the whole truth and nothing but the truth and learn how to dance without a dozen Coronas in me.
As a recovered alcoholic, I’m going to go out on a limb here and say that many doctors unwittingly commit malpractice when they prescribe a narcotic or benzodiazepine without first screening the patient for substance abuse.
Giving Xanax to an addict is a prescription for relapse. It’s not a shame-on-you mistake. It’s an irresponsible, negligent mistake that can be fatal. I’m not just talking about MDs either. I’m talking about the dentist who pulls a wisdom tooth and sends the patient home with a prescription for Percocet.
I have made this argument before and I get riled up every time I hear about a doctor who has done this. The latest case happened here in my hometown and the doctor was actually charged.
Dr. John Christensen, a chiropractor-turned-MD who got his medical degree from a school in the Dominican Republican that closed amid allegations that it was a diploma mill, has been charged with two counts of first-degree murder in the overdose deaths of two patients he treated at his clinic. Besides the two murder charges, Christiansen also faces 89 other charges, mostly trafficking in oxycodone.
Investigators focused on 35 patients from several Florida counties who died after Christensen prescribed them high-powered narcotics. In two of those cases investigators concluded they had enough evidence to charge him with murder.
According to investigators, Christensen prescribed lethal doses of oxycodone, Xanax and methadone to patients who didn’t have legitimate medical needs. In fact, Christensen’s attorneys argued in civil lawsuits that the doctor was trying to help addicts wean themselves from drugs. Christensen settled the suits without admitting wrongdoing.
Although this appears to be a case of a doctor who was operating a pill mill and wrote prescriptions with full knowledge that his patients were addicts, this is a start and hopefully a wake-up call for doctors who don’t bother to screen patients for substance abuse before writing a prescription for these drugs.
I have always wondered why it is that some products we buy without haggling or questioning the price and other products we only purchase after a Law-&- Order worthy cross-examination.
I wouldn’t dream of going into a grocery store and challenging the manager about the price of a loaf of bread or try to finagle a deal. But at a car dealership, it’s expected. We know how much a gallon of gas costs at every gas station because there are signs in front that tell us. That enables us to shop around and get the best deal.
So what’s up with the price of my antidepressants?